Abstract

BackgroundInflammatory cytokines are linked to obesity-related insulin resistance and may predict type 2 diabetes independently of obesity. We previously reported that a majority of a cohort of 73 non-diabetic women with normal plasma (p-)glucose with Amerindian heritage in Lima, Peru, during a 5-year period increased both body weight and p-glucose levels, yet p-insulin was unaltered. A high proportion of palmitoleic acid (16:1n-7) in serum (s) and systolic blood pressure (SBP) were independent predictors of high p-glucose. Whether cytokines also contributed is, however, not known.MethodsDuring 5 years we prospectively investigated the relation between changed concentrations of p-tumor necrosis factor (TNF)-α, p-interleukin (IL)-6 and circulating insulin and glucose in relation to the natural variation of body weight. Study variables included anthropometric measurements, p-insulin, TNF-α, IL-6, SBP and the proportion of 16:1n-7 in s-fatty acid composition.ResultsWeight and waist differences correlated negatively to the difference in p-TNF-α but positively to differences in p-IL-6 and p-insulin, whereas the increase of p-glucose from baseline to follow-up did not correlate with changes in levels of the two cytokines. In multiple regression analysis changes of TNF-α and insulin contributed independently to the variance in weight. P-insulin at baseline and weight change were determinants of fasting p-insulin at follow-up. Multiple regression analysis revealed that weight change (t-value = - 2.42; P = 0.018) and waist change (t-value = 2.41; P = 0.019) together with S-16:1n-7 (p < 0.0001) and SBP (p = 0.0005) at baseline were significant predictors of p-glucose at follow-up.ConclusionOur prospective study of Amerindian women revealed disassociations between changes in p-TNF-α and p-IL-6 in relation to variation in body weight. A high proportion of s-16:1n-7, SBP at baseline together with weight and waist changes were independent predictors of p-glucose at follow-up. The exact role of the opposite effects and clinical impact of p-TNF-α and p-IL-6 on loss and gain of body weight and indirectly on the development of glucose intolerance is not known.

Highlights

  • Inflammatory cytokines are linked to obesity-related insulin resistance and may predict type 2 diabetes independently of obesity

  • In people with type 2 diabetes, the circulating p- IL-6 concentration is correlated with adipose tissue mass, rather than with whole-body insulin sensitivity [9], suggesting that IL-6 may be a marker of obesity without any direct contribution to the development of insulin resistance

  • In subjects who lost body weight p-tumor necrosis factor (TNF)-α and pIL-6 concentrations were unchanged during the followup period

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Summary

Introduction

Inflammatory cytokines are linked to obesity-related insulin resistance and may predict type 2 diabetes independently of obesity. We previously reported that a majority of a cohort of 73 non-diabetic women with normal plasma (p-)glucose with Amerindian heritage in Lima, Peru, during a 5-year period increased both body weight and pglucose levels, yet p-insulin was unaltered. A possibility is that cytokines, such as interleukin (IL)-6 and tumor necrosis factor (TNF)-α, contribute to the development of insulin resistance and impaired islet function. This is, controversial because in a cross-sectional study, neither p-TNF-α nor p-IL-6 levels were independently associated with hepatic or peripheral insulin action [8]. In people with type 2 diabetes, the circulating p- IL-6 concentration is correlated with adipose tissue mass, rather than with whole-body insulin sensitivity [9], suggesting that IL-6 may be a marker of obesity without any direct contribution to the development of insulin resistance

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